ADENOKARSINOMA PROSTAT: PENILAIAN PROGNOSTIK DAN DERAJAT HISTOPATOLOGI

Abstract

Abstrak
Kanker prostat merupakan kanker kedua terbanyak pada pria di seluruh dunia. Tujuan penelitian ini adalah untuk mengetahui faktor prognostik adenokarsinoma prostat seperti derajat histopatologi berdasarkan the 2005 ISUP modified Gleason system, invasi perineural dan kadar PSA serum sebelum operasi. Ini adalah suatu penelitian deskriptif kasus adenokarsinoma prostat yang didiagnosis di laboratorium patologi anatomi periode 2010-2012. Data usia dan kadar PSA diperoleh dari rekam medik. Review sediaan histopatologi dilakukan untuk konfirmasi skor Gleason, lalu dikelompokan berdasarkan derajat histopatologi. Kasus adenokarsinoma prostat yang memenuhi kriteria inklusi adalah 163. Hasil penelitian menunjukkan kasus adenokarsinoma prostat terbanyak pada kelompok usia 61-70 tahun sebanyak 38,65%, derajat histopatologi poorly differentiated yaitu 46,63%, invasi perineural 22,7% dan 83,33% kadar PSA serum >20 ng/ml. Pada kelompok usia 51-60 tahun adenokarsinoma prostat terbanyak ditemukan dengan derajat histopatologi well differentiated; sedangkan kelompok usia 61-70 tahun, 71-80 tahun dan 81-90 tahun terbanyak poorly differentiated. Invasi perineural positif terbanyak pada derajat histopatologi poorly differentiated. Semua derajat histopatologi adenokarsinoma prostat menunjukkan kadar PSA serum terbanyak >20 ng/ml. Penelitian ini menunjukkan kecenderungan peningkatan usia, invasi perineural dan kasus dengan kadar PSA serum >20 ng/ml bersamaan dengan peningkatan derajat histopatologi adenokarsinoma prostat.

Abstract
Prostate cancer is the second most common cancer in men around the world. The objective of this study was to determine prognostic factors of prostate adenocarcinoma such as histopathological grading based on the 2005 ISUP modified Gleason system, perineural invasion, and PSA serum. This was a descriptive study of prostate adenocarcinoma diagnosed in Pathology Department from 2010 to 2012. The age and PSA serum level were taken from the medical records. The histological slides were reviewed to confirm Gleason score, and then classified into the histopathological grading. The number of prostate adenocarcinoma cases included in this study was 163. The result shows that the majority of cases were found at 61–70 years old (38.65%), histopathological grading was mostly poorly differentiated (46.63%), positive perineural invasion 22.7% and 83.33% PSA serum above 20 ng/ml. Prostate adenocarcinomas found at age 51-60 years old were mostly well differentiated. On the other hand, cases found at age above 60 years old were mostly poorly differentiated. Perineural invasion was mostly found on poorly differentiated cases. All of histopathological grading showed PSA serum above 20 ng/ml. This study suggested that higher age, perineural invasion and PSA serum level above 20 ng/ml were congruent with the histopathological grading.